Chapter 32 - Burns

Question 1

Skin has 4 functions

Answer 1

1. Protection from the environment
2. Regulates temperature and fluid
3. Sensory nerves that communicate with the brain
   4. Responds to injury with inflammation

Question 2

What challenges do burn victims have after they have healed?

There are 2 primes challenges

Answer 2

**Difficulty with thermoregulation due to **
1. Inability to sweat
2. Impaired vasoconstriction and vasodilation

**Little or no sensation **

Question 3

Which burn zone is the central area of the skin that suffers the most damage?

a. Zone of coagulation
b. Zone of stasis
c. Zone of hyperemia
d. Zone of hypoemia

Answer 3

a. Zone of coagulation

pg 1642

Question 4

Which burn zone is the area least affected by the thermal injury?

a. Zone of coagulation
b. Zone of stasis
c. Zone of hyperemia
d. Zone of hypoemia

Answer 4

c. Zone of hyperemia

pg 1643

Question 5

What is the man challange of the Zone of stasis?

a. There is little or no blood low to the injured tissue in this area
b. This area may undergo tissue necrosis within 24to 48hours after the injury
c. Cells will typically recover in 7 to 10 days, but are suspectible to infection untl healed fully.

Answer 5

b. This area may undergo tissue necrosis within 24to 48hours after the injury

pg 1643

Question 6

How long does a superficial burn take to heal?

Answer 6

3-7 days

pg 1644

Question 7

How long does it take for a full thickness burn to heal?

Answer 7

This is incapable of self-regeneration on its own.

The basement membrane layer that creates dermal is burned away.

pg 1644

Question 8

Rule of Nines

What is the infant’s head percentage?

Answer 8

18

Question 9

Rule of Nines

What is the infant’s left leg (whole extremity) percentage?

Answer 9

13.5

Question 10

Rule of Nines

What is the infant’s right arm (whole extremity) percentage?

Answer 10

9

Question 11

Rule of Nines

What is the child head percentage?

Answer 11

12

Question 12

Rule of Nines

What is the child’s left leg (whole extremity) percentage?

Answer 12

16.5

Question 13

Rule of Nines

What is the childs’s right arm (whole extremity) percentage?

Answer 13

9

Same as Infant

Question 14

Rule of Nines

What is the adults head percentage?

Answer 14

9

Question 15

Rule of Nines

What is the adults’s left leg (whole extremity) percentage?

Answer 15

18

Question 16

Major Burn

Full-thickness burns covering more than ____% of the TBSA
a.10%
b. 15%
c. 20%
d. 25%

Answer 16

a.10%

pg 1649

Question 17

Major Burn 10-50 years old

Partial-thickness burns covering more than ____%:

a.10%
b. 15%
c. 20%
d. 25%

Answer 17

d. 25%

pg 1649

Question 18

Major Burn < 10 or > 50 years old

Partial-thickness burns covering more than ____%:

a.10%
b. 15%
c. 20%
d. 25%

Answer 18

c. 20%

pg 1649

Question 19

Supericial burns covering more than 50% of the TBSA are considered:

a. Severe Burn
b. Moderate Burn
c. Minor Burn
d. Not considered on the Burn Classifiactions

Answer 19

b. Moderate Burn

Question 20

Supericial burns covering more than ____% of the TBSA are considered Moderate Burns

a. 25%
b. 40%
c. 45%
d. 50%

Answer 20

d. 50%

Question 21

Transport patients with more than ____% of the TBSA
a. 10%
b. 15%
c. 20%
d. 25%

Answer 21

a. 10%

Question 22

What is the Consensus formula (Parkland)?

Answer 22

2 to 4 mL × weight (kg) × % TBSA

Half is given during first 8 hours.
Half is given over the subsequent 16 hours.

Question 23

If an acutely burned patient entries hypovolemic shock in the field, what should you look for?

Answer 23

Look for another injury as the source of shock.

pg 1654

Question 24

If an acutely burned patient entries hypovolemic shock in the field, what should you look for?

Answer 24

Look for another injury as the source of shock.

pg 1654

Question 25

Treatment for burn from Dry Lime (Base/Alkali)

Answer 25

1. Brush as much lime as you can from the skin (wear gloves)! 2.Then start flushing copiously with a garden hose or shower. (Your intention is to completely overwhelm any damaging chemical reaction with a deluge of water.) | If you add water first, the burn will get worse. ## Footnote pg 1657

Question 26

Treatment for burn from Sodium Metals

Answer 26

Cover the burn with oil. Sodium mettal produc heat when mixed with water & may explode. ## Footnote pg 1657

Question 27

Treatment for burns from Hydrofluoric acid

Answer 27

* Calcium gluconate gel * Calcium chloride (CaCl) jelly * May require IV Calcium admin

Question 28

Treatment for burns from Hot Tar

Answer 28

Immerse in cold water to cool tar

Question 29

What are vesicants?

Answer 29

Blister producing agents. Respiratory comproise if inhaled

Question 30

Examples of vesicants

Answer 30

Lewisite Sulfur mustard (mustard gas) Phosgene oxime

Question 31

Treatment for vesicants

Answer 31

1. Decontaminated (usually by soap and copious amounts of water) before XABCDE 2. There are no antidotes for sulfur mustard or phosgene oxime exposure. British anti-lewisite (BAL) is the antidote for lewisite (military). | These are absorbed through skin in **seconds**. PPE

Question 32

Characteristic bull’s-eye lesion at Electrical Burn sites, with a central, _ _ _ _ _ _ ; a middle zone of _ _ _ _ _ _ cold, gray, dry tissue; and an outer, _ _ _ _ _ _ .

Answer 32

1. charred zone of full-thickness burns 2. cold, gray, dry tissue 3. red zone of coagulation necrosis

Question 33

What kind of injury does an acid burn produce?

Answer 33

* Causes immediate pain * **Coagulation necrosis** * Deeper tissue typically not injured

Question 34

What treatment is indicasted for an acid burn?

Answer 34

1. Begin lushing the exposed area of the patient’s body immediately with copious quantities of water 2. Once you think washing is done. Wash the body again, with mild detergent (dishwashing liquid) GENTLY

Question 35

What kind of injury does a(an) base/alkali burn produce?

Answer 35

* Causes little pain * Extensive damage by **liquefaction necrosis**: * * * (breakdown of protein and collagen, saponiication of fats, dehydration of tissues, thrombosis of blood vessels)

Question 36

What kind of injury does an oxydizing agent burn produce?

Answer 36

* Exothermic (heat) reaction * Tissue destruction * Could cause systemic poisoning

Question 37

What kind of injury does a Phosphorus burn produce?

Answer 37

* Burns when exposed to air * Could cause systemic poisoning

Question 38

What kind of injury does a vesicant burn produce?

Answer 38

* Blister agents * Respiratory compromise if inhaled